Ultrasound demonstration of changes in the normal portal venous system following a meal

Bellamy, Elizabeth A.; Bossi, M; Cosgrove, David O.

doi:10.1259/0007-1285-57-674-147

Cited by 33 publications

(12 citation statements)

References 8 publications

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“…10 ·U. 13 Hence, the portal measurements need not to be corrected in respect to physical factors, but are to be specified for respiratory, postural, and prandial status of the subjects.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic measurements of portal vasculature in diagnosis of portal hypertension. A controversial subject reviewed.

Goyal

Pokharna

Sharma

1990

Journal of Ultrasound in Medicine

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In a prospective ultrasound study, the various factors possibly influencing the portal vasculature were evaluated in normal subjects; the correlation of portal diameters with physical factors such as age, sex, and body texture was poor, whereas the caliber variation was significant with respiration, posture, and meal. Considering the fasting state, supine decubitus, and deep inspiration as suitable and standard variables, the diameters were compared in 100 healthy subjects and 50 patients with portal hypertension. The upper normal limits of portal, splenic, and superior mesenteric vein diameters were reported as 16, 12, and 11 mm, respectively, and the dimensions above these values provided an overall sensitivity of 72%, an accuracy of 91%, and a specificity of 100% in diagnosing the patients with suspected portal hypertension.

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“…10 ·U. 13 Hence, the portal measurements need not to be corrected in respect to physical factors, but are to be specified for respiratory, postural, and prandial status of the subjects.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic measurements of portal vasculature in diagnosis of portal hypertension. A controversial subject reviewed.

Goyal

Pokharna

Sharma

1990

Journal of Ultrasound in Medicine

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“…First of all, the conditions in which the measurements were performed were not fully standardized. Bellamy et al reported significant changes in the portal venous system following meals; 20 therefore, all measurements should be performed in the fasting state. Other studies do not refer to the breathing phase in which calibers were measured.…”

Section: Discussionmentioning

confidence: 99%

Splanchnic vein measurements in patients with liver cirrhosis: a case-control study.

Zoli¹,

Dondi²,

Marchesini³

et al. 1985

Journal of Ultrasound in Medicine

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The portal venous system was evaluated by real-time ultrasonography in 100 consecutive cirrhotic patients and 100 pair-matched controls to assess the sensitivity and specificity of ultrasound findings in detecting or excluding cirrhosis. The best discriminant findings were the expiration diameters of the superior mesenteric and the splenic vein and, chiefly. their sum corrected by body surfitce. In cirrhotics the calibers of the splanchnic veins significantly increase in relation to the extent of esophageal varices, but in individual patients this increase cannot predict the extent of varices, which are the main determinant of the bleeding risk. (Key words: liver, cirrhosis of; esophageal varices; portal hypertension; splanchnic vein measurements)Abdominal ultrasonography is being used more extensively in patients with liver cirrhosis. 1 -3 Previous studies have shown that in cirrhotic patients several sonographic findin gs may be observed, including alterations in splanchnic veins such as an increase in the caliber of splanchnic veins, and a diminished response of portal vessels to breathing. · -6The diagnostic usefulness of these findings, however, largely depends on the reliability of control data, which have never been obtained in a large series of matched healthy controls. -1-l'l Enlarged splanchnic vessels are possibly caused by portal hypertension, which is also responsible for the development of esophageal varices. Varices are well-known determinants of survival in these patients; large varices increase the risk of gastrointestinal hemorrhage.11 In a previous report, ultrasonography was proposed as a technique to identify patients with a high risk of bleeding.10 However, only the diameter of splanchnic vessels was considered and no detailed information was given regarding breathing.We report a detailed evaluation of the diagnostic

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“…Portal vein diameter is known to increase following a meal, and the effect can be as much as 50 % [39]. In a small series, this effect has been shown to be present in normal subjects and chronic hepatitis patients alike, but in liver cirrhosis mean calibre, mean flow velocity and mean flow volume remained largely unchanged after a meal [40].…”

Section: Ultrasound Modalitiesmentioning

confidence: 99%

Ultrasound in chronic liver disease

2014

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BackgroundWith the high prevalence of diffuse liver disease there is a strong clinical need for noninvasive detection and grading of fibrosis and steatosis as well as detection of complications.MethodsB-mode ultrasound supplemented by portal system Doppler and contrast-enhanced ultrasound are the principal techniques in the assessment of liver parenchyma and portal venous hypertension and in hepatocellular carcinoma surveillance.ResultsFibrosis can be detected and staged with reasonable accuracy using Transient Elastography and Acoustic Radiation Force Imaging. Newer elastography techniques are emerging that are undergoing validation and may further improve accuracy. Ultrasound grading of hepatic steatosis currently is predominantly qualitative.ConclusionA summary of methods including B-mode, Doppler, contrast-enhanced ultrasound and various elastography techniques, and their current performance in assessing the liver, is provided.Teaching Points• Diffuse liver disease is becoming more prevalent and there is a strong clinical need for noninvasive detection.• Portal hypertension can be best diagnosed by demonstrating portosystemic collateral venous flow.• B-mode US is the principal US technique supplemented by portal system Doppler.• B-mode US is relied upon in HCC surveillance, and CEUS is useful in the evaluation of possible HCC.• Fibrosis can be detected and staged with reasonable accuracy using TE and ARFI.• US detection of steatosis is currently reasonably accurate but grading of severity is of limited accuracy.

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Ultrasound demonstration of changes in the normal portal venous system following a meal

Cited by 33 publications

References 8 publications

Ultrasonic measurements of portal vasculature in diagnosis of portal hypertension. A controversial subject reviewed.

Ultrasonic measurements of portal vasculature in diagnosis of portal hypertension. A controversial subject reviewed.

Splanchnic vein measurements in patients with liver cirrhosis: a case-control study.

Ultrasound in chronic liver disease

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